Transcription

1 Review PS4 (2006) AUSTRALIAN AND NEW ZEALAND COLLEGE OF ANAESTHETISTS ABN RECOMMENDATIONS FOR THE POST-ANAESTHESIA RECOVERY ROOM 1. INTRODUCTION A well-planned, well-equipped, well-staffed and well-managed post-anaesthesia recovery area is essential for the safe early management of patients who have recently undergone a surgical or other procedure, irrespective of the type of anaesthesia or sedation used. 2. GENERAL PRINCIPLES 2.1 Recovery from anaesthesia should take place under supervision in an area designated for the purpose. 2.2 This area should be close to where the anaesthesia or sedation was administered. 2.3 The staff working in this area must be trained for their role and able to contact supervising medical staff promptly when the need arises. 2.4 In some situations (for example, paediatric hospitals) minor variations in these recommendations may be appropriate. 3. DESIGN FEATURES FOR THE RECOVERY AREA 3.1 The area should be part of the operating or procedural suite with easy access for management of emergencies by both theatre medical staff and staff in street clothes from outside the theatre suite. Provision should be made for rapid evacuation of patients from the area in an emergency. 3.2 Ventilation of the area should be of operating theatre standard. 3.3 Space allocated per bed/trolley should be at least 9 square metres. There must be easy access to the patient s head. 3.4 The number of bed/trolley spaces must be sufficient for expected peak loads and there should be at least 1.5 spaces available per operating room. 3.5 The layout of bed spaces should allow staff to have an uninterrupted view of several patients at once. 1

2 3.6 Each bed space must be provided with: an oxygen outlet medical suction complying with relevant national standards two general power outlets appropriate lighting and wall colour to allow accurate assessment of skin colour emergency lighting appropriate facilities for mounting and operating any necessary equipment and for the patient s chart 3.7 Space must be provided for a nursing station, utility room and storage for drugs, equipment and linen. 3.8 There must be appropriate facilities for scrubbing up for procedures. 3.9 There should be a wall clock with a sweep second hand or analogue display clearly visible from each bed space Communication facilities should include: an emergency call system to areas where specialist staff are available a telephone with access to the hospital paging system 3.11 There must be access for portable X-Ray equipment. Appropriate power outlets and viewing box must be available An emergency power supply must be available in the area. 4. EQUIPMENT AND DRUGS 4.1 Each bed space should be provided with: oxygen flowmeter and patient oxygen delivery systems suction equipment including a receiver, appropriate hand pieces and a range of suction catheters pulse oximeter facilities for blood pressure measurement including cuffs suitable for all patients stethoscope means of measuring body temperature 4.2 Within the recovery area there must be: 2

3 4.2.1 means for manual ventilation with oxygen in a ratio of one unit per two bed spaces, but with a minimum of two such devices equipment and drugs for airway management and endotracheal intubation emergency and other drugs a range of intravenous equipment and fluids and a means of warming those fluids drugs for acute pain management a range of syringes and needles patient warming devices devices for measuring expired carbon dioxide 4.3 There should be easy access to: lead electrocardiograph defibrillator neuromuscular function monitor chest drains warming cupboard refrigerator for drugs and blood procedure light basic surgical tray blood gas and electrolyte measurement diagnostic imaging services apparatus for mechanical ventilation of the lungs monitors for direct arterial and venous pressure monitoring 4.4 The recovery trolley/bed must: have a firm base and mattress tilt from one or both ends both head up and head down at least 15 degrees be easy to manoeuvre have efficient and accessible brakes provide for sitting the patient up have secure side rails which must be able to be dropped below the base or be easily removed have an I.V. pole 3

4 4.4.8 have provision for mounting monitoring equipment, apparatus for delivering oxygen, patient ventilation equipment, underwater seal drains and suction apparatus during transport of patients 5. STAFFING 5.1 Staff trained in the care of patients recovering from anaesthesia must be present at all times. 5.2 A registered nurse trained in recovery area care should be in charge. 5.3 Trainee nurses and registered nurses who are not experienced in the care of patients recovering from anaesthesia must be supervised. 5.4 The ratio of registered nurses to patients needs to be flexible so as to provide no less than one nurse to three patients, and one nurse to each patient who has not recovered protective reflexes or consciousness. 6. MANAGEMENT AND SUPERVISION 6.1 Written protocols for management should be established. The Director of Anaesthesia should be responsible for the medical aspects of these policies. 6.2 A written routine for checking the equipment and drugs must be established. 6.3 When an anaesthetised patient is being transferred from one trolley/bed to another, a minimum of three people must assist with lifting. An anaesthetist must be present to have prime responsibility for the patient s head, neck and airway. 6.4 A designated anaesthetist should be contactable in the event that the responsible anaesthetist is unavailable. In larger hospitals, recovery duties should be the designated anaesthetist s primary duty 6.5 Observations should be recorded at appropriate intervals and should include state of consciousness, oxygen saturation, respiratory rate, pulse rate, blood pressure and temperature. 6.6 All patients should remain until they are considered safe to be discharged from the recovery area according to established criteria. 6.7 The anaesthetist responsible for the patient should: accompany the patient until transfer to recovery area staff is completed provide written and verbal instructions to the recovery area staff 4

5 6.7.3 specify the type of apparatus and the flow rate to be used for oxygen therapy remain in the vicinity until the patient is safe to be left in the care of recovery area staff supervise the recovery period and authorise the patient's discharge from the recovery area. It is recognised that in some circumstances it may be necessary for the anaesthetist previously responsible for the patient to delegate these duties to a trained recovery area nurse or to another anaesthetist who should be fully informed of the clinical state of the patient 6.8 The practitioner responsible for the patient s overall care should be available to consult with the anaesthetist in the recovery period if necessary and, in appropriate circumstances, authorise the discharge of the patient. COLLEGE PROFESSIONAL DOCUMENTS College Professional Documents are progressively being coded as follows: TE EX PS T Training and Educational Examinations Professional Standards Technical POLICY defined as a course of action adopted and pursued by the College. These are matters coming within the authority and control of the College. RECOMMENDATIONS defined as advisable courses of action. GUIDELINES defined as a document offering advice. These may be clinical (in which case they will eventually be evidence-based), or non-clinical. STATEMENTS defined as a communication setting out information. This document has been prepared having regard to general circumstances, and it is the responsibility of the practitioner to have express regard to the particular circumstances of each case, and the application of this document in each case. Professional documents are reviewed from time to time, and it is the responsibility of the practitioner to ensure that the practitioner has obtained the current version. Professional documents have been prepared having regard to the information available at the time of their preparation, and the practitioner should therefore have regard to any information, research or material which may have been published or become available subsequently. 5

6 Whilst the College endeavours to ensure that professional documents are as current as possible at the time of their preparation, it takes no responsibility for matters arising from changed circumstances or information or material which may have become available subsequently. College Website: Promulgated: 1989 Reviewed: 1994, 1995, 2000 Date of current document: Aug

1 8 OPERATING THEATRE AND ANAESTHETIC SERVICES OVERVIEW OF OPERATING THEATRE AND ANAESTHETIC SERVICES Services in the operating theatre and anaesthetic services carry high risk. It is essential that there

Guidelines for the Practice of Anesthesia in Norway History 1991 1st version 1994 1st revision 1998 2nd revision 2005 3rd revision on 19.03.05 by NAF (The Norwegian Society of Anesthesiology) 1 Table of

Page 1 of 16 Guidelines for Transport of the Critically Ill Version Effective Date 1 May 1994 2 Feb 2002 3 Apr 2014 Document Number Prepared by College Guidelines Committee Endorsed by HKCA Council Next

Analgesia and Moderate Sedation This Nebraska Board of Nursing advisory opinion is issued in accordance with Nebraska Revised Statute (NRS) 71-1,132.11(2). As such, this advisory opinion is for informational

The Challenge of Aero-medical Critical Care Transport. Focus on critical cases air-ambulance only In-flight 8,000 Ft. Logistics of intrahospital transfers Is the transfer absolutely necessary? What are

PS03 2014 Australian and New Zealand College of Anaesthetists (ANZCA) Faculty of Pain Medicine Guidelines for the Management of Major Regional Analgesia 1. OVERVIEW This document is intended to apply to

Joint Working Group to produce guidance on delivering an Endovascular Aneurysm Repair (EVAR) Service. Royal College of Radiologists British Society of Interventional Radiology The Vascular Society of Great

COLLEGE OF INTENSIVE CARE MEDICINE OF AUSTRALIA AND NEW ZEALAND ABN 16134 292 103 AND AUSTRALIAN AND NEW ZEALAND COLLEGE OF ANAESTHETISTS ABN 82055 042 852 AND AUSTRALASIAN COLLEGE FOR EMERGENCY MEDICINE

.goo NON HOSPITAL MEDICAL AND SURGICAL FACILITIES PROGRAM College of Physicians and Surgeons of British Columbia Liposuction GUIDELINE You may download, print or make a copy of this material for your noncommercial

Humpty s Wish List helping put kids back together The following items have been requested by some of the hospitals and health services that Humpty currently supports. Each item has been assessed and approved

Guidelines for Standards of Care for Patients with Acute Respiratory Failure on Mechanical Ventilatory Support Copyright by the SOCIETY OF CRITICAL CARE MEDICINE These guidelines can also be found in the

LONDON DEANERY PROVIDER SUPPORT OPERATIONS DEPARTMENT FOUNDATION PROGRAMME Policy Name Foundation Doctor Role and Responsibilities within the Local Education Provider and Minimum Requirements for Clinical

PDF Version [Printer friendly ideal for printing entire document] EMERGENCY MEDICAL ASSISTANTS REGULATION 562/2004 Published by DISCLAIMER: These documents are provided for private study or research purposes

Page 1 of 21 GENERAL PATIENT UNIT When assigned to the General Patient unit paramedic student should gain knowledge and experience in the following: 1. Appropriate communication with patients and members

Page 1 The (IPVN) has many important responsibilities and plays many roles within the hospital. They apply their professional skills in anesthesia, surgery, dentistry, laboratory testing, patient nursing

Regions Hospital Delineation of Privileges Certified Registered Nurse Anesthetist Applicant s Name: Last First M. Instructions: Place a check-mark where indicated for each core group you are requesting.

246-976-320 Air ambulance services. The purpose of this rule is to ensure the consistent quality of medical care delivered by air ambulance services in the state of Washington. (1) All air ambulance services

RECOMMENDATIONS FOR SEDATION AND ANALGESIA BY NON-ANAESTHESIOLOGISTS TERUS MAJU College of Anaesthesiologists Academy of Medicine of Malaysia Academy of Medicine of Malaysia December 2012 With the participation

INTERNATIONAL FEDERATION OF NURSE ANESTHETISTS Standards of Education, Practice, Monitoring and Code of Ethics Revised 25 May 2012 All rights reserved IFNA, 2012 1 Standards and Code of Ethics INTERNATIONAL

Final Classification Standards December 2007 Series Overview This series is comprised of three classifications with progressive responsibility for nursing care and services and administrative duties within

My Operation A Message for Parents & Carers This book has been compiled by the Hospital Play Coordinators and Theatre Staff to help explain admission and surgery to parents and their patients. Every year

Gloucestershire Hospitals NHS Foundation Trust TRUST CLINICAL POLICY In the case of hard copies of this policy the content can only be assured to be accurate on the date of issue marked on the document.

Intravenous Therapy Medications or therapeutic solutions may be injected directly into the bloodstream for immediate circulation and use by the body. State practice acts designate which health care professionals

Summary: CH CONSCIOUS SEDATION It is the policy of Carondelet Health that moderate conscious sedation of patients will be undertaken with appropriate evaluation and monitoring. Effective Date: 9/4/04 Revision

Page: 1 of 8 I. SCOPE: This policy applies to Saint Francis Hospital, its employees, medical staff, contractors, patients and visitors regardless of service location or category of patient. This policy

Oxygenation Chapter 21 Anatomy and Physiology of Breathing Inspiration ~ breathing in Expiration ~ breathing out Ventilation ~ Movement of air in & out of the lungs Respiration ~ exchange of O2 & carbon

Having a Fibroid Embolisation Information for Patients In this leaflet: Introduction 2 What is fibroid embolisation? 2 Why do I need fibroid embolisation? 2 Who has made the decision?. 2 Who will be doing

JOB PROFILE Job Title : Senior Dental Nurse (Luton Patch) Managed by : Operations Manager Accountable to : Operations Director Job Purpose : To undertake the day to day management of clinics and support

Chapter II Introduction The Director has a major role in the effort to provide high quality medical care with a high degree of clinical safety. He is ultimately responsible for the professional conduct

1. Basic hospital vocabulary. Rearrange the letters in brackets to form the correct word. People in hospital with some form of illness are known as. (ptientas). When they first arrive at hospital, a doctor

2011 Central Venous Lines (CVP) Central Venous Line This pamphlet is about a central venous pressure (CVP) line and why it may be needed. We would like to encourage you to read this pamphlet. The nurses

Using Pulse Oximeters Tutorial 1 the basics 1 World Health Organization, 2011. WHO, All rights 2011. reserved. The Pulse Oximeter In this tutorial you will learn about: The function of a pulse oximeter

Colon Cancer Surgery and Recovery A Guide for Patients and Families This Booklet You are receiving this booklet because you will be having surgery shortly. This booklet tells you what to do before, during,

Nurses Station & Resident Call System PRE 1975: NEW YORK Downloaded 01.15.11 713 1.3 Nursing units. Each nursing unit shall include the following service areas and shall meet the following minimum requirements:

Laparoscopic Cholecystectomy Brief description: This is an operation to remove the gall bladder using key-hole surgical techniques. The gall bladder is being removed because it is giving you pain due to

Goals and Objectives for the General Surgery Rotation Resident PGY1 Hamilton Health Sciences or St. Joseph Healthcare (2 four-week rotational blocks) Overview During the first year of their residency training

Guidelines for the Safe Transportation of Individuals Who Rely Upon Stretchers and Personal Mobility Devices in Vehicles Other than an Ambulance Washington State Department of Health Office of Community

Your spinal Anaesthetic Information for patients Your spinal anaesthetic This information leaflet explains what to expect when you have an operation with a spinal anaesthetic. It has been written by patients,

Epidural Continuous Infusion Patient information Leaflet April 2015 Introduction You may already know that epidural s are often used to treat pain during childbirth. This same technique can also used as